Decision Report 201703848

Summary

Mr C complained on behalf of his late wife (Mrs A) about the treatment she received at Monklands Hospital. Mrs A attended her GP with pain in her right chest wall and was referred to hospital for an x-ray which found no significant abnormalities. Mrs A later attended her GP with worsening shoulder pain and her GP sent an urgent referral to the orthopaedics department (the branch of medicine concerned with the musculoskeletal system). This referral was downgraded by the board from urgent to routine. Mrs A was later diagnosed with bone and liver cancer. Mr C complained that the board unreasonably failed to check the x-ray for signs of cancer and that they unreasonably downgraded the urgent referral to routine.

We took independent advice from a consultant radiologist. We found that Mrs A had been referred for an x-ray due to an injury and that an x-ray is not the correct test to reliably pick up on a tumour. We also noted that the x-ray had showed a subtle change in bony texture of the clavicle (collar bone). As Mrs A had been referred for an x-ray due to an injury and the abnormality was so subtle, it would have been unreasonable to expect a radiologist to pick this up. Therefore, we did not uphold this aspect of Mr C's complaint.

In relation to the referral downgrade, we took independent advice from a consultant physician. We found that the orthopaedic referral letter did not suggest any need for the appointment to be urgent, no mention of cancer and no indication that the problem was considered to be anything other than shoulder pain that had not responded to physiotherapy. Therefore, we did not uphold this aspect of Mr C's complaint.